[ Search ] [ Legislation ]
[ Home ] [ Back ] [ Bottom ]
[ Engrossed ] | [ Enrolled ] | [ Senate Amendment 001 ] |
91_SB1613 LRB9112970JSpc 1 AN ACT concerning the care of Alzheimer's disease 2 patients. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Alternative Health Care Delivery Act is 6 amended by changing Sections 30 and 35 as follows: 7 (210 ILCS 3/30) 8 Sec. 30. Demonstration program requirements. The 9 requirements set forth in this Section shall apply to 10 demonstration programs. 11 (a) There shall be no more than: 12 (i) 3 subacute care hospital alternative health 13 care models in the City of Chicago (one of which shall be 14 located on a designated site and shall have been licensed 15 as a hospital under the Illinois Hospital Licensing Act 16 within the 10 years immediately before the application 17 for a license); 18 (ii) 2 subacute care hospital alternative health 19 care models in the demonstration program for each of the 20 following areas: 21 (1) Cook County outside the City of Chicago. 22 (2) DuPage, Kane, Lake, McHenry, and Will 23 Counties. 24 (3) Municipalities with a population greater 25 than 50,000 not located in the areas described in 26 item (i) of subsection (a) and paragraphs (1) and 27 (2) of item (ii) of subsection (a); and 28 (iii) 4 subacute care hospital alternative health 29 care models in the demonstration program for rural areas. 30 In selecting among applicants for these licenses in rural 31 areas, the Health Facilities Planning Board and the -2- LRB9112970JSpc 1 Department shall give preference to hospitals that may be 2 unable for economic reasons to provide continued service to 3 the community in which they are located unless the hospital 4 were to receive an alternative health care model license. 5 (a-5) There shall be no more than a total of 12 6 postsurgical recovery care center alternative health care 7 models in the demonstration program, located as follows: 8 (1) Two in the City of Chicago. 9 (2) Two in Cook County outside the City of Chicago. 10 At least one of these shall be owned or operated by a 11 hospital devoted exclusively to caring for children. 12 (3) Two in Kane, Lake, and McHenry Counties. 13 (4) Four in municipalities with a population of 14 50,000 or more not located in the areas described in 15 paragraphs (1), (2), and (3), 3 of which shall be owned 16 or operated by hospitals, at least 2 of which shall be 17 located in counties with a population of less than 18 175,000, according to the most recent decennial census 19 for which data are available, and one of which shall be 20 owned or operated by an ambulatory surgical treatment 21 center. 22 (5) Two in rural areas, both of which shall be 23 owned or operated by hospitals. 24 There shall be no postsurgical recovery care center 25 alternative health care models located in counties with 26 populations greater than 600,000 but less than 1,000,000. A 27 proposed postsurgical recovery care center must be owned or 28 operated by a hospital if it is to be located within, or will 29 primarily serve the residents of, a health service area in 30 which more than 60% of the gross patient revenue of the 31 hospitals within that health service area are derived from 32 Medicaid and Medicare, according to the most recently 33 available calendar year data from the Illinois Health Care 34 Cost Containment Council. Nothing in this paragraph shall -3- LRB9112970JSpc 1 preclude a hospital and an ambulatory surgical treatment 2 center from forming a joint venture or developing a 3 collaborative agreement to own or operate a postsurgical 4 recovery care center. 5 (a-10) There shall be no more than a total of 8 6 children's respite care center alternative health care models 7 in the demonstration program, which shall be located as 8 follows: 9 (1) One in the City of Chicago. 10 (2) One in Cook County outside the City of Chicago. 11 (3) A total of 2 in the area comprised of DuPage, 12 Kane, Lake, McHenry, and Will counties. 13 (4) A total of 2 in municipalities with a 14 population of 50,000 or more and not located in the 15 areas described in paragraphs (1), (2), or (3). 16 (5) A total of 2 in rural areas, as defined by the 17 Health Facilities Planning Board. 18 No more than one children's respite care model owned and 19 operated by a licensed skilled pediatric facility shall be 20 located in each of the areas designated in this subsection 21 (a-10). 22 (a-15) There shall be an authorized community-based 23 residential rehabilitation center alternative health care 24 model in the demonstration program. The community-based 25 residential rehabilitation center shall be located in the 26 area of Illinois south of Interstate Highway 70. 27 (a-20) There shall be an authorized Alzheimer's disease 28 management center alternative health care model in the 29 demonstration program. The Alzheimer's disease management 30 center shall be located in Will County. 31 (b) Alternative health care models, other than a model 32 authorized under subsection (a-20), shall obtain a 33 certificate of need from the Illinois Health Facilities 34 Planning Board under the Illinois Health Facilities Planning -4- LRB9112970JSpc 1 Act before receiving a license by the Department. If, after 2 obtaining its initial certificate of need, an alternative 3 health care delivery model that is a community based 4 residential rehabilitation center seeks to increase the bed 5 capacity of that center, it must obtain a certificate of need 6 from the Illinois Health Facilities Planning Board before 7 increasing the bed capacity. Alternative health care models 8 in medically underserved areas shall receive priority in 9 obtaining a certificate of need. 10 (c) An alternative health care model license shall be 11 issued for a period of one year and shall be annually renewed 12 if the facility or program is in substantial compliance with 13 the Department's rules adopted under this Act. A licensed 14 alternative health care model that continues to be in 15 substantial compliance after the conclusion of the 16 demonstration program shall be eligible for annual renewals 17 unless and until a different licensure program for that type 18 of health care model is established by legislation. The 19 Department may issue a provisional license to any alternative 20 health care model that does not substantially comply with the 21 provisions of this Act and the rules adopted under this Act 22 if (i) the Department finds that the alternative health care 23 model has undertaken changes and corrections which upon 24 completion will render the alternative health care model in 25 substantial compliance with this Act and rules and (ii) the 26 health and safety of the patients of the alternative health 27 care model will be protected during the period for which the 28 provisional license is issued. The Department shall advise 29 the licensee of the conditions under which the provisional 30 license is issued, including the manner in which the 31 alternative health care model fails to comply with the 32 provisions of this Act and rules, and the time within which 33 the changes and corrections necessary for the alternative 34 health care model to substantially comply with this Act and -5- LRB9112970JSpc 1 rules shall be completed. 2 (d) Alternative health care models shall seek 3 certification under Titles XVIII and XIX of the federal 4 Social Security Act. In addition, alternative health care 5 models shall provide charitable care consistent with that 6 provided by comparable health care providers in the 7 geographic area. 8 (d-5) The Illinois Department of Public Aid, in 9 cooperation with the Illinois Department of Public Health, 10 shall develop and implement a reimbursement methodology for 11 all facilities participating in the demonstration program. 12 The Illinois Department of Public Aid shall keep a record of 13 services provided under the demonstration program to 14 recipients of medical assistance under the Illinois Public 15 Aid Code and shall submit an annual report of that 16 information to the Illinois Department of Public Health. 17 (e) Alternative health care models shall, to the extent 18 possible, link and integrate their services with nearby 19 health care facilities. 20 (f) Each alternative health care model shall implement a 21 quality assurance program with measurable benefits and at 22 reasonable cost. 23 (Source: P.A. 91-65, eff. 7-9-99.) 24 (210 ILCS 3/35) 25 Sec. 35. Alternative health care models authorized. 26 Notwithstanding any other law to the contrary, alternative 27 health care models described in this Section may be 28 established on a demonstration basis. 29 (1) Alternative health care model; subacute care 30 hospital. A subacute care hospital is a designated site 31 which provides medical specialty care for patients who 32 need a greater intensity or complexity of care than 33 generally provided in a skilled nursing facility but who -6- LRB9112970JSpc 1 no longer require acute hospital care. The average length 2 of stay for patients treated in subacute care hospitals 3 shall not be less than 20 days, and for individual 4 patients, the expected length of stay at the time of 5 admission shall not be less than 10 days. Variations 6 from minimum lengths of stay shall be reported to the 7 Department. There shall be no more than 13 subacute care 8 hospitals authorized to operate by the Department. 9 Subacute care includes physician supervision, registered 10 nursing, and physiological monitoring on a continual 11 basis. A subacute care hospital is either a freestanding 12 building or a distinct physical and operational entity 13 within a hospital or nursing home building. A subacute 14 care hospital shall only consist of beds currently 15 existing in licensed hospitals or skilled nursing 16 facilities, except, in the City of Chicago, on a 17 designated site that was licensed as a hospital under the 18 Illinois Hospital Licensing Act within the 10 years 19 immediately before the application for an alternative 20 health care model license. During the period of operation 21 of the demonstration project, the existing licensed beds 22 shall remain licensed as hospital or skilled nursing 23 facility beds as well as being licensed under this Act. 24 In order to handle cases of complications, emergencies, 25 or exigent circumstances, a subacute care hospital shall 26 maintain a contractual relationship, including a transfer 27 agreement, with a general acute care hospital. If a 28 subacute care model is located in a general acute care 29 hospital, it shall utilize all or a portion of the bed 30 capacity of that existing hospital. In no event shall a 31 subacute care hospital use the word "hospital" in its 32 advertising or marketing activities or represent or hold 33 itself out to the public as a general acute care 34 hospital. -7- LRB9112970JSpc 1 (2) Alternative health care delivery model; 2 postsurgical recovery care center. A postsurgical 3 recovery care center is a designated site which provides 4 postsurgical recovery care for generally healthy patients 5 undergoing surgical procedures that require overnight 6 nursing care, pain control, or observation that would 7 otherwise be provided in an inpatient setting. A 8 postsurgical recovery care center is either freestanding 9 or a defined unit of an ambulatory surgical treatment 10 center or hospital. No facility, or portion of a 11 facility, may participate in a demonstration program as a 12 postsurgical recovery care center unless the facility has 13 been licensed as an ambulatory surgical treatment center 14 or hospital for at least 2 years before August 20, 1993 15 (the effective date of Public Act 88-441). The maximum 16 length of stay for patients in a postsurgical recovery 17 care center is not to exceed 48 hours unless the treating 18 physician requests an extension of time from the recovery 19 center's medical director on the basis of medical or 20 clinical documentation that an additional care period is 21 required for the recovery of a patient and the medical 22 director approves the extension of time. In no case, 23 however, shall a patient's length of stay in a 24 postsurgical recovery care center be longer than 72 25 hours. If a patient requires an additional care period 26 after the expiration of the 72-hour limit, the patient 27 shall be transferred to an appropriate facility. Reports 28 on variances from the 48-hour limit shall be sent to the 29 Department for its evaluation. The reports shall, before 30 submission to the Department, have removed from them all 31 patient and physician identifiers. In order to handle 32 cases of complications, emergencies, or exigent 33 circumstances, every postsurgical recovery care center as 34 defined in this paragraph shall maintain a contractual -8- LRB9112970JSpc 1 relationship, including a transfer agreement, with a 2 general acute care hospital. A postsurgical recovery 3 care center shall be no larger than 20 beds. A 4 postsurgical recovery care center shall be located within 5 15 minutes travel time from the general acute care 6 hospital with which the center maintains a contractual 7 relationship, including a transfer agreement, as required 8 under this paragraph. 9 No postsurgical recovery care center shall 10 discriminate against any patient requiring treatment 11 because of the source of payment for services, including 12 Medicare and Medicaid recipients. 13 The Department shall adopt rules to implement the 14 provisions of Public Act 88-441 concerning postsurgical 15 recovery care centers within 9 months after August 20, 16 1993. 17 (3) Alternative health care delivery model; 18 children's respite care center. A children's respite 19 care center model is a designated site that provides 20 respite for medically frail, technologically dependent, 21 clinically stable children, up to age 18, for a period of 22 one to 14 days. This care is to be provided in a 23 home-like environment that serves no more than 10 24 children at a time. Children's respite care center 25 services must be available through the model to all 26 families, including those whose care is paid for through 27 the Illinois Department of Public Aid or the Illinois 28 Department of Children and Family Services. Each respite 29 care model location shall be a facility physically 30 separate and apart from any other facility licensed by 31 the Department of Public Health under this or any other 32 Act and shall provide, at a minimum, the following 33 services: out-of-home respite care; hospital to home 34 training for families and caregivers; short term -9- LRB9112970JSpc 1 transitional care to facilitate placement and training 2 for foster care parents; parent and family support 3 groups. 4 Coverage for the services provided by the Illinois 5 Department of Public Aid under this paragraph (3) is 6 contingent upon federal waiver approval and is provided 7 only to Medicaid eligible clients participating in the 8 home and community based services waiver designated in 9 Section 1915(c) of the Social Security Act for medically 10 frail and technologically dependent children. 11 (4) Alternative health care delivery model; 12 community based residential rehabilitation center. A 13 community-based residential rehabilitation center model 14 is a designated site that provides rehabilitation or 15 support, or both, for persons who have experienced severe 16 brain injury, who are medically stable, and who no longer 17 require acute rehabilitative care or intense medical or 18 nursing services. The average length of stay in a 19 community-based residential rehabilitation center shall 20 not exceed 4 months. As an integral part of the services 21 provided, individuals are housed in a supervised living 22 setting while having immediate access to the community. 23 The residential rehabilitation center authorized by the 24 Department may have more than one residence included 25 under the license. A residence may be no larger than 12 26 beds and shall be located as an integral part of the 27 community. Day treatment or individualized outpatient 28 services shall be provided for persons who reside in 29 their own home. Functional outcome goals shall be 30 established for each individual. Services shall include, 31 but are not limited to, case management, training and 32 assistance with activities of daily living, nursing 33 consultation, traditional therapies (physical, 34 occupational, speech), functional interventions in the -10- LRB9112970JSpc 1 residence and community (job placement, shopping, 2 banking, recreation), counseling, self-management 3 strategies, productive activities, and multiple 4 opportunities for skill acquisition and practice 5 throughout the day. The design of individualized program 6 plans shall be consistent with the outcome goals that are 7 established for each resident. The programs provided in 8 this setting shall be accredited by the Commission on 9 Accreditation of Rehabilitation Facilities (CARF). The 10 program shall have been accredited by CARF as a Brain 11 Injury Community-Integrative Program for at least 3 12 years. 13 (5) Alternative health care delivery model; 14 Alzheimer's disease management center. An Alzheimer's 15 disease management center model is a designated site that 16 provides a safe and secure setting for care of persons 17 diagnosed with Alzheimer's disease. An Alzheimer's 18 disease management center model shall be a facility 19 separate from any other facility licensed by the 20 Department of Public Health under this or any other Act. 21 An Alzheimer's disease management center shall conduct 22 and document an assessment of each resident every 6 23 months. The assessment shall include an evaluation of 24 daily functioning, cognitive status, other medical 25 conditions, and behavioral problems. An Alzheimer's 26 disease management center shall develop and implement an 27 ongoing treatment plan for each resident. The treatment 28 plan shall have defined goals and include the use of 29 cholinesterase inhibitors, if clinically indicated, to 30 treat cognitive decline, referral to appropriate 31 structured activities such as exercise, recreation, and 32 adult day care services, and appropriate medical care. 33 The Alzheimer's disease management center shall treat 34 behavioral problems and mood disorders using -11- LRB9112970JSpc 1 nonpharmacologic approaches such as environmental 2 modification, task simplification, and other appropriate 3 activities. An Alzheimer's disease management center 4 shall provide education and support for residents and 5 caregivers. The education and support shall include 6 referrals to support organizations for educational 7 materials on community resources, support groups, legal 8 and financial issues, respite care, and future care needs 9 and options. The education and support shall also 10 include a discussion of the resident's need to make 11 advance directives and to identify surrogates for medical 12 and legal decision-making. The provisions of this 13 paragraph establish the minimum level of services that 14 must be provided by an Alzheimer's disease management 15 center. 16 (Source: P.A. 91-65, eff. 7-9-99; 91-357, eff. 7-29-99.) 17 Section 10. The Alzheimer's Special Care Disclosure Act 18 is amended by changing Section 10 as follows: 19 (210 ILCS 4/10) 20 (Text of Section before amendment by P.A. 91-656) 21 Sec. 10. Facility defined. As used in this Act, 22 "facility" means a facility licensed or permitted under the 23 Nursing Home Care Act, the Life Care Facility Act,orthe 24 Community Living Facilities Licensing Act, or subsection 25 (a-20) of Section 30 of the Alternative Health Care Delivery 26 Act. 27 (Source: P.A. 90-341, eff. 1-1-98.) 28 (Text of Section after amendment by P.A. 91-656) 29 Sec. 10. Facility defined. As used in this Act, 30 "facility" means a facility licensed or permitted under the 31 Nursing Home Care Act, the Life Care Facility Act, the 32 Assisted Living and Shared Housing Act,orthe Community -12- LRB9112970JSpc 1 Living Facilities Licensing Act, or subsection (a-20) of 2 Section 30 of the Alternative Health Care Delivery Act. 3 (Source: P.A. 90-341, eff. 1-1-98; 91-656, eff. 1-1-01.) 4 Section 95. No acceleration or delay. Where this Act 5 makes changes in a statute that is represented in this Act by 6 text that is not yet or no longer in effect (for example, a 7 Section represented by multiple versions), the use of that 8 text does not accelerate or delay the taking effect of (i) 9 the changes made by this Act or (ii) provisions derived from 10 any other Public Act. 11 Section 99. Effective date. This Act takes effect upon 12 becoming law.